How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Facility | None | $38.90 | $38.90 | $38.90 |
Aetna Setting Professional Modifier None Typical Low $35.48 Median $36.31 Typical High $38.90 | Professional | None | $35.48 | $36.31 | $38.90 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | None | $45.71 | $45.71 | $45.71 |
Cigna Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | None | $22.39 | $22.39 | $22.39 |
Medica Setting Facility Modifier None Typical Low $35.48 Median $39.81 Typical High $69.18 | Facility | None | $35.48 | $39.81 | $69.18 |
Medica Setting Professional Modifier None Typical Low $18.62 Median $34.67 Typical High $288.40 | Professional | None | $18.62 | $34.67 | $288.40 |
United Setting Facility Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Facility | None | $52.48 | $52.48 | $52.48 |
United Setting Professional Modifier None Typical Low $10.00 Median $18.62 Typical High $32.36 | Professional | None | $10.00 | $18.62 | $32.36 |
4 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $17.78 Median $18.20 Typical High $19.50 | Professional | 52 · Reduced service | $17.78 | $18.20 | $19.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.08 Median $7.24 Typical High $7.76 | Professional | 53 · Discontinued | $7.08 | $7.24 | $7.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.25 Median $5.50 Typical High $5.89 | Professional | 55 · Aftercare only | $5.25 | $5.50 | $5.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $3.63 Typical High $3.89 | Professional | 56 · Pre-op care only | $3.55 | $3.63 | $3.89 |
Where Oklahoma sits
The same service costs 3.3 times more in Montana than in Missouri. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Oklahoma· 25th of 51
$34.67
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.